How accurate are rice sizers?

Question

Made rice sizers using 1&1/2 C rice (360 cc's) and put them in a sports bra. Not sure what kind of profile they resemble closest? Moderate? I am 5'7&1/2", 125lbs, slim athletic build, 34B. The size wasn't huge, but looked wide in the chest. Maybe it was the sports bra? Would a high profile help avoid looking wide in the chest? Want to look proportionate and natural, going for a full C look. Dr said I don't have a wide breast base, 11.something I believe. Suggestions? Rice sizers looked a little strange.

Jerome Edelstein, MD · Answer

Hello,Using rice sizers is not precise or a good indication of the exact shape or feel of your breasts however they can be useful to give you and idea of how different volumes will look on you and in your clothes at home. My patients prefer to try on the implant sizers in a bra, with a form-fitting T-Shirt ion the office. This is not completely representative of final results either but can give you a very good idea of the look and feel you can expect from implants. When choosing between very different projections or large size differences, Sizers can help. If you are debating between differences of a couple millimeters or 20 cc of volume, that is likely to precise to gauge with rice sizers. Ask your Plastic Surgeon to guide you based on your measurements and stated goals.All the best

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you is dictated by your
chest wall measurements.  Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look,
then the diameter of the implant should be equal to or, more ideally, smaller
than the width of your breast. The breast width is a measurement of how wide
your breast is at the base, which should be measured at the level of the
nipple. Choosing an implant that is smaller in diameter than your breast width
will avoid the "side breast" fullness that is often associated with a
more artificial appearance.  Other than that, you should choose the
implant based on volume, not on the dimensions of the implant. You should
choose a board certified plastic surgeon that you trust to help guide you in
this decision.

Silicone will give you a fullness at the
top (upper pole fullness).

Silicone implants come pre-filled with a
silicone gel and are the softest implant available. They feel more natural,
which makes them a good option for women with less natural breast tissue; but
they require a larger incision. It may be more difficult to realize if this
type of implant has ruptured, so it is important to monitor them with annual
follow-up visits. Additionally, because this implant contains a more liquid
silicone (less cross-linked), if this implant should rupture, it will leak only
into the scar capsule formed around the implant but may cause some discomfort
or implant distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone
gel implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and try
on various implant sizers in front of a mirror to help you to get an idea of
how you will look following the surgery. You should also bring pictures of the
look you would like to achieve, as well as a favorite top to wear when trying
on implant sizers.

The best way to assess and give true
advice would be an in-person exam.

Please see a board-certified plastic
surgeon that specializes in aesthetic and restorative breast surgery.Best of luck!

Dr. Schwartz

Manish H. Shah, MD, FACS · Answer

Hello marylittle,Thanks for your question.For all intents and purposes, a rice sizer gives the most important piece of information about a potential breast augmentation.  Once you find a size you like, you can start sizing with your surgeon at this volume and make adjustments as necessary.  Your surgeon will find the correct width and profile to best match your chest wall anatomy.I always recommend the use of rice or sugar sizers.  It certainly helps me guide the patient better.A high profile implant is the most common implant I place to avoid an overly wide augmentation.I hope this was helpful.Good luck,Dr. Shah

Peter D. Geldner, MD · Answer

In a word, we can do better. Rice sizers give a rough idea of what kind of volume you want. It's a start. I prefer the Mentor sizing system. It's much more accurate. Physical dimensions are very important. The best approach is three dimensional photographic simulation with the Vectra system.Take your time, get second opinions. You'll know it when you see it.

Steven Wallach, MD · Answer

Rice sizers are a good rough estimate for volume.  A profile can be often chosen based upon the volume to match the patient's anatomy.  Best of luck

Nicholas Tarola, MD · Answer

Thank you for your question.  I do not believe rice sizers provide a good representation of what implants will ultimately look like.  Even sizing systems that I and many other surgeons use in the office setting are not completely accurate but, because of their design, provide patients with a reasonable picture of what to expect with a certain size implant.  Your surgeon will make recommendations on implant size and type based on your measurements and goals.  The sizing system simply gives you an idea of what a certain volume will look like on your frame.  I hope this helps.  Best wishes!

Robert Shenker, MD · Answer

Sizing for breast implants is not an exact science. We use all kinds of methods including using actual replicas of the implant as trial sizers, and three-dimensional photography and digital simulation which are all useful techniques. However, discussing your pre-surgical anatomy and your aesthetic goals with an experienced and well trained plastic surgeon is BY FAR  the best way to come to a decision regarding implant size.Also, please remember that becoming fixated on one specific implant size and believing that that is the only size that will work for you is not a healthy way to think about breast implants. For almost every patient there is a range of breast implant sizes that can be made to work and produce beautiful results. That's why taking your time with an experienced surgeon is a great strategy to get you the result you want.I hope this helps!Dr. Robert Shenker MD FRCSC

Peter E. Johnson, MD · Answer

A rice sizer is helpful for some if they are well measured and made, though the implants themselves might be more easily used. The purpose of the sizer is not as much for the "number" as the look you are after. This is what needs to be communicated to your surgeon so the result is the one you wish for.

Todd C. Case, MD · Answer

In a word, no.  the best size for your chest and beast is best determined by your breast and chest dimensions.  If your breast are 11 cm or so in base width, you will need to pick an implant that is less than or equal to 11 cm or so in width.  If you max out the width, then to gain more volume, you will need to pick a higher profile implant.  The larger and higher the profile, the less natural the result tends to be, but this is not an absolute.

Tom J. Pousti, MD · Answer

Although useful as rough guidelines and as communication tools, all the modalities currently used to predict what breast implant size/profile will best achieve a patient's goals with breast augmentation are not very accurate, in my opinion. The use of the rice test, sizers placed beneath a patient's bra, goal pictures, computer imaging technology… are all useful, but not necessarily as accurate as one would hope.In my opinion, nothing will replace careful verbal preoperative communication with your plastic surgeon, preferably in front of a full-length mirror along with the use of as many "communication" tools” listed above.In my practice, I use all of the above modalities and then use intraoperative temporary sizers to help determine the best breast implant size/profile to achieve a patient's specific goals as closely as possible. For this reason, I think it is helpful to have the entire range of breast implant  sizes/profiles available in the operating room.Achieving realistic expectations prior to proceeding to the operating room is also an important part of the preoperative communication process. Patients should be aware that the results of their breast augmentation will not necessarily match exactly what they are visualizing with anyone of the above-mentioned communication tools.Given your questions and concerns, and given that your surgery is coming up soon, I would suggest that you schedule additional time to spend with your plastic surgeon. This additional time spent will be helpful in the communication process and in alleviating some of your anxiety.In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C cup" etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.Best wishes; hopefully you will be very pleased with the outcome of the planned procedure.

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